Atrial natriuretic hormone, the renin-aldosterone axis, and blood pressure-electrolyte homeostasis.
Atrial natriuretic hormone, the renin-aldosterone axis, and blood pressure-electrolyte homeostasis.
复制标题
心房钠尿激素、肾素-醛固酮轴和血压-电解质稳态。
DOI：
10.1056/nejm198511213132106
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Laragh,JH
中科院分区：
文献类型：
--
作者：
Laragh,JH
肾素-血管紧张素-醛固酮轴主要控制钠钾平衡和动脉血压。这三种功能持续受到血管紧张素II和醛固酮水平变化的调节，血管紧张素II和醛固酮水平变化是对钠和钾饮食摄入量变化的反应。此外，肾内物理因素的变化引起远端肾小管钠供应的变化，这反过来又决定钠和钾的排泄并调节肾肾素的释放。然而，某些方面的钠稳态不能完全解释的活动的肾素系统或肾内的物理因素，这导致研究人员寻找其他利钠激素机制。最近，心房组织中含有一组肽，其中至少有一种可能是作为调节激素分泌的。在动物中，这些心房肽产生与肾小球滤过率升高（但不改变总肾流量）和动脉血压同时降低相关的立即、显著的尿钠排泄。心房肽还抑制肾肾素分泌和肾上腺皮质分泌醛固酮，并且它们对抗血管紧张素II的血管收缩作用。因此，这些心房肽中的一种可能是长期寻找的利钠激素，尽管其形式和形状与想象的不同。心房肽在四个点上作用于对抗肾素系统，这一事实表明这种新激素可能在血压和电解质稳态的长期调节中发挥重要的补充作用。在这种结构中，肾素系统主要保护钠平衡和血压，心房激素在涉及高血压或钠过量的情况下具有越来越大的反作用。我们很快就可以了解更多关于这种心房激素的信息，包括哪种肽是活跃的循环激素，是什么诱导或抑制其释放，以及它在心血管疾病中起什么作用。
The renin-angiotensin-aldosterone axis exerts major control over sodium and potassium balance and arterial blood pressure. These three functions are continuously regulated by changes in angiotensin II and aldosterone levels in response to wide variations in dietary intake of sodium and potassium. In addition, changes in intrarenal physical factors cause changes in the supply of distal tubular sodium that, in turn, work to determine sodium and potassium excretion and to modulate the release of renal renin. However, certain aspects of sodium homeostasis cannot be fully explained either by the activity of the renin system or by intrarenal physical factors, and this has led investigators to search for other natriuretic hormonal mechanisms. Recently, it has become clear that atrial tissue contains a group of peptides, at least one of which is probably secreted as a regulatory hormone. In animals, these atrial peptides produce immediate, marked natriuresis associated with a rise in glomerular filtration rate (but no alteration of total renal flow) and a simultaneous decrease in arterial blood pressure. Atrial peptides also inhibit renal renin secretion and adrenal cortical secretion of aldosterone, and they oppose the vasoconstrictive action of angiotensin II. One of these atrial peptides may therefore be the long-sought natriuretic hormone, though in a different form and shape than was envisioned. The fact that atrial peptide works to oppose the renin system at four points suggests that this new hormone could have a major complementary role in long-term regulation of blood pressure and electrolyte homeostasis. In this construction the renin system primarily defends sodium balance and blood pressure, with the atrial hormone having an increasing counter-influence in situations involving high blood pressure or sodium surfeit. We can soon expect to learn more about this atrial hormone, including which peptide is the active circulating hormone, what induces or inhibits its release, and what part it plays in cardiovascular diseases.